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<br />OWNER'S NAMB1l1le~ ~'QGk& <br />JOB SITE ADDRESS 5 3 ~ a S c a-f ; 01. ~-t. <br /> <br />CITY OF ZBPHYRHILLS PBRMIT APPLICATION <br />BUJ:LDtNQ DIIPARTIiJmT 5335 8t:h STREIIT ZBPRYRBJ:LLS, rL- 33540 <br />PhoneI813-780-0020 raxI813-780-0021 <br />DATil RIICII:IVBD <br />PLANS RBVIBK rRE <br /> <br />PHONB CONTACT 7 ~ 3-79/-; <br /> <br />SUBDIVISION S hq J y Qe d <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BWCl( <br /> <br />P~CEL ID ff 1 0 ~ -b ')..1 - 0 0 / (j - 0 CJ.3 00. \)\jO(). (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONBW CONSTRUCTION - D ADDITIqN <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />D DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWli;LLING <br /> <br />D COMMERCIAL <br /> <br />DMuLTI - FAMILY <br />o INDUSTRIAL <br /> <br />Off OF UNITS <br />D SWIMMING POOL <br /> <br />-BtMOBILE HOMB <br />D OTHER <br /> <br />o RESTAURANT &: HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORl( \Z~ Rt)~{ wi ~)' tljle. fly RV1bbeo Mety)b{qrt~ <br />BUILDING SIZB SQUARB FooTAGB <6 ~ S HBIGHT <br /> <br />RBStDBNTIAL: <br />COMMERCIAL: <br /> <br />ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SBT ENERGY FORMS. <br />ATTACH (3) SBTS OF BUILDING PLANS &: (1) SBT ENERGY FORMS. <br />PROPERTY SURVEY RBQUIRED FOR ALL NBW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />$ , ~16b. <br /> <br />PBRMITS. RBQUBSTBD <br />sjg.. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SBRVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MBCHANCIAL INSTALLATION <br /> <br />o GAS J!rRobFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION I 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLQOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE ARRAo YES 0 NO <br /> <br />, : ' -, " ' .,., -, . "'.' <br />I . .'" <br />. , ~. '" '. <br /> <br />BU:ILDJUt <br />SIGNATURE. ~ .--L?~~ <br /> <br />COMPANY ....;:::70nc, :t k. r1s-s aL <br />STATE CERT OR REGIST ff cCc 01/1..167 <br />CITY PROCESSING ff <br /> <br />................................**......................**.***.*.. <br /> <br />BLRCTR:IC:IJUII <br /> <br />COMPANY <br />STATE CERT OR REGrST ff <br />CITY PROCESSING ff <br /> <br />SIGNATURE <br /> <br />******..*******************.***.*.***********.**.**.**.*.....*.... <br /> <br />PLUllBBR <br /> <br />COMPANY <br />STATE CERT OR REGIST ff <br />CITY PROCESSING ff <br /> <br />SIGN1\.TURE <br /> <br />MBCIlAHICAL <br /> <br />*..*....*......*.....*......................*.**................*. <br /> <br />COMPANY <br />STATE CERT OR REGIST ff <br />CITY PROCESSING ff <br /> <br />SIGNATURE <br /> <br />*****....***..**.***..*.*~*..**......**.*..*...........**..**.... <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST ff <br />CITY PROCESSING ff <br /> <br />*****..*.*..*.....**...................................**....*.*. <br />